The new approach would ensure that service-related ailments that are better-treated by the VA will continue to be treated there, while more universal maladies are treated in a patient's community.
The VA Choice Program is set to sunset later this year and Shulkin is hopeful that legislation to launch the new program will be passed by the end of the fiscal year in September.
Advocacy groups such as Disabled American Veterans support the new vision. Adrian Atizado, deputy national legislative director for the group, told lawmakers at the hearing he believed the changes would make accessing appropriate care, both in and outside the VA, easier than it is now under the Choice program.
"I've been looking forward to this hearing because Choice has been such a train wreck," said Sen. Jon Tester (D-Mont.), ranking member on the committee. "It was supposed to increase availability of healthcare, and it's done just the opposite." Veterans in his state and elsewhere have said it has been hard to get a timely appointments, and providers say it takes too long to get paid under the program.
In April, President Donald Trump signed legislation meant to address the provider payment issue. The VA had been relying on a third-party vendor to oversee payments. Starting this summer, the VA will pay claims directly.
Other committee members wanted assurances that the VA would continue working to improve its own care capabilities and that the Trump administration wasn't attempting to totally privatize care for veterans. The VA system has at least 45,000 provider vacancies.
"If you only give your customers a choice to get out, you're going to rob the resources from a system that we need to make sure is working," Sen. Patty Murray (D-Wash.) said.
Shulkin said he agreed and insisted that work is continuing to also ensure access to care in the VA system.